METHODS: The medical records of 1,500 aortic procedures performed at our center were queried from 2002-2011. Relevant data from patients needing explantation of aortic endografts was analyzed.

RESULTS: Thirty-six patients underwent aortic explantation (63.9% male). Mean age was 71.6 years with a mean aneurysm size of 6.6cm (range 3.5-10.7 cm). Hypertension (97%), hyperlipidemia (77.8%) and smoking (83%) were the most prevalent risk factors. Mean time to explant was 45.3 months (range 2.2-118.4 months). The primary explant indication was endoleak in 24 (66.7%) and infection in 12 (33.3%) patients. Thirty-day morbidity was 54% (endoleak) and 83% (infection). There were 2 deaths (16.7%) in the infection group within 30 days. Five patients were symptomatic, while 2 patients had ruptured aneurysms. In the endoleak group, there were 9 type Ia, 7 type II, 1 type III, 3 type V, 1 rupture and 3 patients with multiple endoleaks. Seventy-eight percent of patients were alive at a mean follow-up of 17. 4 months.

CONCLUSIONS: This is the largest endograft explantation series to date. Patients with an infectious etiology have significantly worse morbidity and mortality than patients requiring explantation for endoleaks.

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